Locking Compression Plate Versus Dynamic or Limited Contact Dynamic Compression Plate Fixation for Forearm Fractures:
Ali Rteil1, Majd Mzeihem2, Brendon Wang3
1Department of Orthopaedic Surgery, Endeavor Health, an Affiliate of the University of Chicago Pritzker School of Medicine, Skokie, Illinois, USA.
Summary
Locking compression plates (LCPs) offer faster radiographic union for forearm fractures compared to dynamic compression plates (DCPs). However, LCPs do not show significant advantages in healing rates, function, or complications, despite higher costs.
Area of Science:
- Orthopedic surgery
- Biomaterials engineering
Background:
- Locking compression plates (LCPs) provide angular stability, potentially aiding complex forearm fractures.
- LCPs are more expensive than traditional dynamic compression plates (DCPs) and limited contact DCPs (LC-DCPs).
Purpose of the Study:
- To compare union time, functional outcomes, and complications between LCPs and non-locking plates for diaphyseal radius and ulna fractures.
- To evaluate the cost-effectiveness and clinical utility of LCPs in forearm fracture management.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Inclusion of eight studies with 525 patients comparing LCPs with DCPs or LC-DCPs.
- Pooled analysis of radiographic and clinical outcomes using random-effects models.
Main Results:
- LCPs demonstrated a significantly shorter mean time to union compared to DCPs.
- No significant differences were observed in delayed union, nonunion, overall complications, functional scores, or range of motion between LCPs and DCPs.
- LCPs showed a non-significant trend toward shorter union time versus LC-DCPs, with similar functional outcomes and complication rates.
Conclusions:
- LCP fixation offers a modest reduction in radiographic union time compared to DCPs for forearm fractures.
- LCPs do not provide clear advantages in union rates, functional outcomes, or complication profiles over non-locking plates.
- Given the increased cost and potential removal difficulties, LCPs should be selectively indicated rather than routinely used for all forearm fractures.
